Epidemiology
40% in individuals age >70.
The risk of malignancy in any given cyst is quite low (~0.01%), and many can be managed conservatively with surveillance imaging.
High risk for malignancy
- Large size (?3cm)
- Solid components or calcifications
- Main pancreatic duct involvement (ie, ductal dilation)
- Thickened or irregular cyst wall
Management
- Endoscopic ultrasound (EUS) – guided biopsy
- Minimally invasive approach to tissue sampling for high risk lesions.
- Surgical resection
- May be considered for very high-risk lesions.
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